The course will cover the anatomical and functional basis to the evaluation of pain disorders of the spine. Of special interest will be clinical practice, emphasizing clinical examination, evaluation, interpretation, differential diagnosis and treatment. Evidence based practice is an important aspect of the programme, but only where evidence exists! Classification of spinal pain disorders and subsequent sub-category based treatment strategies is the way forward in manual therapy, and there is increasing evidence to support this.

This course will be conducted in lecture, tutorial and workshop format for the clinician or academic who is interested in manual therapy, manual medicine or musculoskeletal medicine. It is anticipated that the course content will be suitable to individuals who are seeking new knowledge, to individuals seeking to expand their knowledge and to those individuals seeking the stimulation of clinical interaction. Whilst the course will be presented at a high level this should not be seen as a barrier to participation for those with little or with no previous experience in this special area. As a result of attending the course it is anticipated that participants will gain personal satisfaction as in a variety of ways that will enhance their individual requirements. There are therefore no pre-requisites for participation

Anatomy, pathoanatomy, age related changes and biomechanics of the spine.

Regional assessment of the spine and pelvis

Obtain relevant information from the subjective history

Analyse posture types and the relationship of posture type to normal movement and specific spinal dysfunction

Course Philosophy

This manual therapy programme is aimed at merging the examination of the joint, muscle and neural systems into an integrated wholistic examination procedure. We place strong emphasis on teaching clinicians the ability to perform an accurate and specific manual therapy examination.

The examination process developed by Manual Concepts draws on the work of among others Edwards, Monaghan, Elvey, O’Sullivan, Jull, Sahrmann, Lee, Maitland, Mulligan, Mckenzie etc. We believe that the merger of the work of these manual therapists into one concept provides a more realistic, multifactorial approach to the examination and treatment procedure.

Joint System

As part of the assessment of the joint system we aim to teach a range of passive motion testing procedures to include provocative tests for specific structures as well as tests to determine specific motion segment dysfunction. A significant aspect of the assessment procedure is the use of combined movements as developed by Brian Edwards. Equally important is the use of specific passive segmental motion testing and provocative tests for pain reproduction. Current research demonstrates that identification of joint hypo/hyper mobility and subsequent treatment based on this classification improves treatment outcomes.

Neural System

Neural tissue dysfunction is an important aspect of the physical examination. A comprehensive overview of neural tissue pain disorders is presented before assessment procedures and differential diagnosis for 3 types of neural dysfunction, neuropathic pain with central sensitization, neuropathic pain with peripheral nerve trunk sensitization and neuropathic pain with denervation (axonal compromise). Assessment to distinguish these problems will be demonstrated and practiced. The clinical relevance of distinguishing these different types of disorders will be presented, particularly in relation to management.

Muscle System

An emphasis of this programme is a functional approach to the assessment of the spinal muscle system and spinal motor control. As well we address the theoretical concept of spinal instability and the signs and symptoms that are commonly found on clinical examination of motor control impairment, including assessment procedures for the local muscle system. It is important to recognize that not all patients require motor control retraining. There is ample evidence to suggest that only a small proportion of patient have instability. Treating all chronic low back pain patients with stabilization through specific multifidus and transversusabdominis exercise is not appropriate and the literature shows this does not work. Determining which patients need a muscle retaining approach is an important part of this programme. A systematic graded, functional approach to the management of patients with spinal motor control impairment will be taught.

A core principle of the programme is the ongoing analysis of the examination findings from the subjective and physical examination procedures. To ascertain an appropriate manual therapy diagnosis critical analysis is developed through clinical reasoning applied to specific case studies.

This programme does not provide the participants with a recipe approach to treatment. Students will be able to develop though sound methodology, appropriate treatment strategies with logical progression over time.

Aims

At the completion of the eight day program the participants will:

Be conversant in recent developments in anatomy, patho-anatomy and age related changes of the spinal column

There is no pre-requisite in terms of manual therapy experience. The programme offers a high level of information and clinical expertise, providing all participants regardless of previous clinical experience and knowledge with a stimulating learning environment. Previous programme participants have recommended the Certificate in Spinal Manual Therapy. They have reported excellent feedback in terms of material content, presenters’ knowledge, and practical supervision.

About the Presenter

Toby Hall and Kim Robinson are internationally respected teachers of manual therapy. Both are based at Curtin University, Perth Western Australia, where they hold the positions of Adjunct Senior Teaching Fellows. Toby and Kim have many years experience of teaching manual therapy at a postgraduate level, lecturing in many countries on aspects of spinal manual therapy. Both have written a range of book chapters and published many articles in relation to researching the evidence base of Manual Therapy. Further details of their publications and teaching experience can be seen on Manual Concepts website.

Module 3 is taught by Peter Fazey. He is a specialist musculoskeletal physiotherapist and Fellow of the Australian College of Physiotherapists.

He graduated in 1983 and gained his post graduate qualifications in manipulative therapy from Curtin University, Perth, Australia in 1986. He has worked primarily in private practice for 25 years though has been involved in teaching manipulative and musculoskeletal physiotherapy for the last 15 years both privately and at Curtin University.

Currently he is lecturer in manual therapy and clinical programs coordinator at the University of Western Australia – Centre for Musculoskeletal Studies where he is undertaking a PhD in lumbar spine biomechanics.

He has published preliminary findings from his doctoral studies and contributed to several chapters in texts on manual therapy including Grieve’s Modern Manual Therapy.

Peter is current National President of the Australian Physiotherapy Association 2007 – 2008. He is also a Director of the Australian Physiotherapy Council and a Director of the Physiotherapy Research Foundation.